Welcome! Blood, guts, trauma, surgery, and life saving intervention keep us on the adrenaline roller coaster of the ER. Of course, it's not always positive. The ER can be an emotionally taxing and sometimes heartbreaking workplace, and this blog serves as an outlet for the stress of making life and death decisions each and every day.

Monday, October 8, 2012

I'd sat around for the first 13 hours of my 14 hour shift, anxiously watching the clock and waiting for the time to go home. Having no patients for an entire day renders me a little stir-crazy.
And then it happened, 45 minutes before the end of my shift. Doorbell rings, technician greets a new client at the door. Dog is a 7 year old, muzzled, growling Sharpei. The client is bleeding from her face, hands and both legs. We all don gloves and start to ask for details of the situation.

"My dog got attacked by a pit-pull!" she screams. "You know how them pit-pulls are!" (no, that is not a typo. She wrote and pronounced it in this manner).

My technician answered "yes, I do know how they are. I have one, and she's the sweetest dog on earth.
....
Now, why are you bleeding?"

The woman replies that her OWN "sweetie" bit her on the face, legs and hands. She baby talks her dog as it snarls, growls and snaps at her and everyone who approaches it. From a distance, I can see he has multiple bites and lacerations over his back and neck, which require flushing and surgery, as well as probably drains and closure. These are big wounds - but I can't get near enough to actually see the extent of the injuries.

I've dealt with a lot of scared pets over my years in the ER. I know how to read them, approach them, and when to give them space. This dog wasn't simply scared, this dog was unsocialized, aggressive, fearful AND dangerous. In order to be able to even get within 4 feet of her, we had to find some way to protect ourselves from the client's fate. I wish I had a dart gun (like they use on wild animals), but alas, we don't keep those lying around since 99% of our patients are friendly (or at least approachable!). We sent the client to the human ER to get her wounds addressed while we took care of her dog. As she left, she didn't seem to understand the gravity of the situation.

"Bye sweetie, mommy loves you" she cooed, as the dog growled and snarled AT HER. "Mommy will be right back to take you home." I was dumbfounded - how do you get bitten in the face, and not realize that your dog is a terror, a danger to society, and could someday kill a child, someone's pet, or at least seriously maim an adult!?

Unfortunately, this patient was so nasty that it took all of my staff's strength, a rabies pole, three broken leashes, a broken muzzle (meaning she could now bite us un-hindered), three doses of drugs and 45 minutes to be able to get this dog even close to a handleable state. Once an adequate level of sedation was finally achieved, I took care of her gnarly wounds and recovered her, carefully. The great news was that none of my staff or myself got injured - but the bad news is this dangerous dog is back out in the world, with no hope of training, rehabilitation, or any sort of behavioral therapy to help treat her obvious anxiety, fear, and socialization issues. Regardless of the fact that we risked injury to ourselves, had to clean up the poop and urine sprayed around the clinic for hours, and cared for this woman's dog, she still would complain about the fact that my record indicated that her dog "had bitten." You know what? I'm here to tell the truth, not the truth as you see it.

I ended up leaving work 2 hours late that night, exhausted, frustrated and with no real reward. Usually I'm happy to have fixed an animal, even if the owner is awful, but this time, I worry that fixing the animal could result in future harm for some other creature. Euthanize? I think it probably would have been the right thing to do, but there's no way that this client could see her "sweetie" for what she truly was - anything but.

All stories contained within this blog are inspired by my life as an emergency veterinarian. Details including but not limited to name, time of visit, species, and age are changed to protect the innocent and crazy alike. Any relationship to persons or animals, living or dead, is purely coincidental.

This isn't web DVM....

These stories are shared to inspire and to entertain. They are not intended to be medical advice. If your pet is sick, the only rational thing to do is have him or her seen (in real life) by a veterinarian.

Who is that masked woman, anyway?

Ever since I was little, I always had the dream of becoming a veterinarian. The dream has been realized, and my passion is emergency medicine. ER work has many pitfalls and disadvantages, but for me, the ability to be there in a moment of crisis and help both a beloved pet and their loving family, is worth the bad days.

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Definitions and commonly seen conditions

Anemia: Low PCV (see below). Anemia can result from external hemorrhage, internal hemorrhage, destruction of blood cells in the body, or inability to make new blood cells in the bone marrow.

Azotemia: Elevation in the BUN (blood urea nitrogen) or creatinine. BUN and creatinine are body wastes typically eliminated by the kidneys; increased levels in the body indicate kidney dysfunction, obstruction of urine, or severe dehydration.

Congestive Heart Failure (CHF): Accumulation of fluid in the lungs due to failure of the heart. Some symptoms include shortness of breath, decreased appetite, rapid breathing rates, coughing, and weakness.

Feline Lower Urinary Tract disease (also called feline idiopathic cystitis): A condition resulting in frequent, painful urination, and in the most severe cases, obstruction of the urethra. FLUTD has several potential causes and is also an extreme emergency.

GDV: Gastric dilatation and volvulus. Occurs in large breed dogs; the stomach fills with gas and twists. An extreme emergency, this condition is treated with stabilization and immediate surgery.

PCV: Packed cell volume. The percentage of red blood cells contained within a given sample of whole blood. Normal for dogs and cats is typically 35%-45%.